Compassionate Empathy
The last form of empathy is perhaps the most contestable. Compassionate empathy is a drive to help others.13 It’s an altruistic trait that inextricably ties the patient and the clinician to one another in a meaningful way. Compassionate empathy is a transcendence of the transactional nature—that a patient is more than a 99215 CPT code or a 30-minute return slot. It’s the impulse that what we are doing has a significant and very real impact on one another.
As with everything else, compassionate empathy rests on harmony with emotional and cognitive empathy. In the rheumatology clinic, compassionate empathy tethers us to the therapeutic nature of our interventions. After all, we don’t prescribe immune modulators to reduce ESR and CRP levels but do so out of a desire to improve the longevity and the quality of life of our patients.
There wasn’t much discussed about compassionate empathy at the mandatory five-hour patient communication course, presumably because the end point wasn’t about compassionate empathy. After all, the ultimate principle driver of these sorts of re-education sessions is about improving patient satisfaction numbers and, ultimately, compensation and money.
Regardless, it’s important to have that compassionate empathy with patients because it centers our actions toward well-being for both patients and clinicians. Having longitudinal contact and seeing the impacts of care can help to further support a practice of compassionate empathy. I would also like to believe that compassionate empathy is a mundane, but nevertheless radical, act of defiance against a heavily corporatized healthcare system.
Social Empathy
While cognitive empathy, emotional empathy, and compassionate empathy are three components of empathy in a very commonly used framework to understand empathy, they aren’t the only components. A more recently articulated form of empathy is social empathy—“the ability to more deeply understand people by perceiving or experiencing their life situations and as a result gain insight into structural inequalities and disparities.”14
Rheumatologists have a unique role in developing this sort of social empathy. Our patients are disproportionately from marginalized and minoritized communities, and an increasing body of evidence demonstrates that immune dysfunction is linked to various socioeconomic determinants of health.15,16 Gaining insight into these inequalities and disparities is a major aspect of being a good rheumatologist, and at every encounter, we should be gaining more and more insights into how our clinical practice interacts with the larger world.
Putting it together, these three components of empathy, plus social empathy, are essential for clinical practice and for the positive outcomes we seek, including patient satisfaction and personal well-being.
